A scoping review of instruments used to assess disordered eating in children and adolescents with higher weight

Abstract Background Disordered eating behaviors are prevalent among children and adolescents with overweight and obesity but are frequently overlooked or underrecognized. We performed a scoping review to identify and map which self- and proxy-report instruments which have been utilized to identify disordered eating in children and adolescents with overweight or obesity. Method A literature search was conducted by searching five databases (OVID Medicine, Embase, PsycInfo, PubMed, Cochrane Systematic Reviews/Cochrane Central Register of Controlled Trials) from 1994 to 2025. We included studies that administered a self-report or proxy-report questionnaire to dimensionally assess disordered eating behavior in samples aged 8 to 19 years in which a majority (≥ 50%) of participants had overweight or obesity. Published articles in English or a Scandinavian language were included. Results In total, there were 2086 hits and 1416 studies were screened after the removal of duplicates using the Covidence review management tool. Of these, 1198 were deemed irrelevant based on titles/abstracts and 218 studies were assessed for eligibility. After full-text review, 75 studies from 22 countries were included. A total of 25 instruments had been administered, ranging in length from 5 items to 91 items. The different versions (e.g., adult/child, abbreviated) of the Eating Disorder Examination-Questionnaire and the Dutch Eating Behavior Questionnaire were the most frequently administered tools, followed by the Three-Factor Eating Questionnaire and the Eating Attitudes Test. The Binge Eating Scale was the most frequently administered tool that specifically assessed binge eating. Conclusions This scoping review highlights several challenges and limitations facing the assessment of disordered eating among children and adolescents with higher weight. The most frequently used instruments were originally designed for adults, women, and individuals classified with underweight or normal weight. Several tools had been modified for younger age or reading level, but none were reportedly modified with respect to higher BMI or weight status of the children. Moving forward, there is a need to develop instruments which are suitably and sensitively designed or adapted for youth with overweight and obesity.